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This can lead to an aggravation of hepatic steatosis (fatty liver), particularly in individuals with pre-existing liver damage ( Studies suggest that in some cases, the KD may induce metabolic dysregulation in liver fatty acid metabolism, causing an accumulation of triglycerides and free fatty acids within hepatocytes ( 4.2.3.2 Increased metabolic burden on the liver The KD imposes a significant metabolic burden on the liver, particularly in individuals whose liver function is already compromised ( For individuals with pre-existing liver disease or reduced hepatic function, this increased metabolic stress may lead to further liver damage

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